We performed three maneuvers of the positional test in supine patients: (1) body maneuver, in which patients turned only the body to one side while keeping the head as still as possible; (2) head-only maneuver, in which patients turned only the head to one side while keeping the body still; ...

Multiple system trauma can occur in accidents, natural disasters, and deliberate attacks, and vital areas of the body, such as the head, chest, and abdomen, may be affected. Investigators in the present study sought to examine morphologic and morphometric alterations of leukocyte responses in patients with multiple trauma during the ...

This study prospectively examined the care of trauma patients in extremis on presentation to a tertiary medical center between January 2000 and August 31, 2002. There were 144 patients who presented without a pulse or spontaneous respiration and required cardiopulmonary resuscitation (mean age, 41.5+/-2.3 years; male-to-female ratio, 105:39). Successfully resuscitated ...

Transthyretin (TTR) which exists in various isoforms, is a valid marker for acute phase response and subclinical malnutrition. The aim of the study was to investigate the relationship between inflammation, oxidative stress and the occurrence of changes in microheterogeneity of TTR.A prospective, observational study at a level-I trauma center of ...

BACKGROUND: Beta-adrenoreceptor blocker (beta-blocker) therapy may improve outcomes in surgical patients by decreasing cardiac oxygen consumption and hypermetabolism. Because beta-blockers can lower the systemic blood pressure and cerebral perfusion pressure, there is concern regarding their use in patients with head injury. However, beta-blockers may protect beta-receptor rich brain cells by ...

Chronic ischemia produces corresponding tissue hypoplasia. However, the present paper reports a distinctive hypertrophy of the intestine due to chronic mesenteric artery insufficiency. Two patients with chronic mesentery artery insufficiency confirmed by angiography are presented. The first patient demonstrated marked hypertrophy of the intestine, while the second patient was remarkable ...

OBJECTIVES: The purpose of this study is to identity the recovery process of the corticospinal tract with diffuse axonal injury (DAI) using diffusion tensor imaging (DTI). DESIGN: A 47-year-old female patient and six age-matched control subjects were evaluated. The patient presented with quadriparesis (more severe in the right extremities than ...

A retrospective review of 42 patients with spaghetti wrist lacerations operated on by the author between June 1997 and May 2005 was completed. A total of 31 males and 11 females, average age of 17.1 years (range, 2-40 years), sustained spaghetti wrist injuries. The most frequent mechanisms of injury were ...

Fortunately with improvements in initial medical resuscitation, such as the avoidance of nephrotoxins, the incidence of acute kidney injury requiring renal support in patients with acute traumatic brain injury remains low. However the incidence of cerebral hemorrhage in patients on chronic dialysis programs appears to be increasing. By carefully adapting ...

The purpose of this study was to carefully examine the effects of a complicated vs uncomplicated mild traumatic brain injury (MTBI) on acute neuropsychological outcome. Participants were derived from an archival trauma database. This is a retrospective matched groups design. All patients were seen through a Head Injury Trauma Service ...

BACKGROUND: Traumatic injuries are a major cause of morbidity and mortality in children. The purpose of the present study was to determine the incidence of nonaccidental trauma (NAT) and to compare the outcomes of accidental trauma (AT) patients with NAT patients at a large pediatric trauma center. METHODS: A retrospective ...

In the US and Western Europe, trauma is the fourth most common cause of death and the leading cause of death in the population less than 45 years of age [Mullinix and Foley, J Comput Assist Tomogr 28(Suppl 1):S20-S27, 2004]. Diaphragmatic injuries occur in 0.8 to 8% of patients after ...

AIM: Traumatic extradural haematoma (EDH) is a neurosurgical emergency and timely surgical intervention for significant EDH is the gold standard. This study aims to determine the incidence and mortality of consecutive patients with traumatic EDH admitted to the Emergency Department (ED) of Prince of Wales Hospital (PWH), a University Hospital ...

BACKGROUND: Acellular meniscus tissue is at a high risk for degeneration and retear. Information that would help surgeons predict, preoperatively, or intraoperatively which torn menisci had few viable cells could be useful in deciding which patients might be at increased risk for retear and failure of surgical repair. HYPOTHESIS: Patient ...

BACKGROUND: The goals of this study were to determine the incidence and duration of hypotension and hypoxia in the prehospital setting in patients with potentially survivable brain injuries, and to prospectively examine the association of these secondary insults with mortality and disability at hospital discharge. METHODS: Trauma patients with suspected ...

Significant traumatic brain injury (TBI) is nearly always associated with cognitive deficits, but in a highly variable manner. Apolipoprotein E (ApoE) plays a pivotal role in CNS response to injury. To examine the association of ApoE genotype with long-term outcome in TBI patients, we determined the ApoE genotype from 61 ...

The purpose of this study is to describe the clinical and radiographic presentation of cuboid fractures in children and to produce a guide for appropriate evaluation and treatment.Twenty-eight consecutive patients with cuboid fracture treated at the same institution between 1998 and 2004 were retrospectively analyzed. The mean age at presentation ...

BACKGROUND: Obtaining a patent airway can be difficult in patients with traumatic airway injuries (TAI). There is a paucity of data available about the incidence of airway compromise and techniques used in these patients. METHODS: Charts review of all patients with TAI treated in a Regional Trauma Center from July ...

BACKGROUND: Professional horse riding-related injuries have not been studied before in Hong Kong, although horse racing takes place very regularly in the territory. In addition, the equestrian events of the 2008 Beijing Olympic Games will come to Hong Kong. This study analysed the pattern of horse-related injury among patients who ...

Background: The hippocampus and corpus callosum have been shown to be vulnerable in head injury. Various neuroimaging modalities and quantitative measurement techniques have been employed to investigate pathological changes in these structures. Cognitive and behavioural deficiencies have also been well documented in head injury. Aims: The aim of this research ...

Appropriate fluid management of patients with traumatic brain injury (TBI) presents a challenge for many clinicians. Many of these patients may receive osmotic diuretics for the treatment of increased intracranial pressure or develop sodium disturbances, which act to alter fluid balance. However, establishment of fluid balance is extremely important for ...

To see if a public awareness campaign might be justified around Halloween with regard to the dangers of egg throwing. A prospective study was carried out of all patients who attended the St Paul's Eye Unit's Primary Care Department with ocular injuries resulting from a thrown egg over a 14-month ...

Many patients with mild traumatic brain injury (MTBI) concurrently sustain extracranial injuries; however, little is known about the impact of these additional injuries on outcome. We assessed the impact of additional injuries on the severity of postconcussional symptoms (PCS) and functional outcome 6 months post-injury. A questionnaire (including the Rivermead ...

BACKGROUND: Bispectral Index (BIS) derived from electroencephalogram (EEG) is primarily developed to monitor the depth of unconsciousness. Recent evidence suggests that BIS may also help in the detection of cerebral ischemia and prognostication of outcome of traumatic brain injury (TBI). The present study was designed to investigate the correlation between ...

We describe the first year of operation of a rural emergency medical retrieval service (EMRS), staffed by emergency medicine and anaesthetic consultants and providing air based retrieval of critically ill and injured patients from general practitioner led community hospitals in rural west Scotland. Data were collected on all patients referred ...

BACKGROUND: As obesity continues to run rampant in our society, an understanding of its adverse effect after traumatic injury is starting to unfold. We hypothesize that obesity negatively impacts head-injured patients, and the current study intends to compare obese and lean patients with traumatic brain injury (TBI). METHODS: This is ...

BACKGROUND AND PURPOSES: Non-operative management (NOM) has revolutionized the care of blunt hepatic and splenic trauma patients. The objective of this study is to evaluate treatment of such patients in a Greek level I trauma centre, to identify factors that are important for selecting them for NOM and to investigate ...

BACKGROUND: Obesity is an independent risk factor for a variety of diseases, including postinjury morbidity and mortality. Obesity is associated with a proinflammatory state that could affect the postinjury inflammatory response and increase risk of organ dysfunction. The purpose of this study was to determine the relationship between obesity and ...

BACKGROUND: The abdomen is routinely considered as a possible source of bleeding in hypotensive and unevaluable blunt multitrauma patients. These patients are often unstable to be transported for abdominal computed tomography (CT). Emerging data on Focused Assessment with Sonography for Trauma (FAST) exam questions its initially reported high accuracy. We ...

INTRODUCTION: The objective of this study was to study the clinical course and outcome of warfarinised patients who were hospitalised because of head trauma. METHODS: 13 patients (ten males and three females; median age 69 years) who presented to the Royal Perth Hospital, Australia and who had suffered a head ...

This study evaluates whether an initial blood glucose level is similarly predictive of injury severity and outcome as admission lactate in trauma patients. Between February 2004 and June 2005, we prospectively compared patients with presenting blood sugars of < or =150 mg/dL (LBS) with those with blood sugars >150 mg/dL ...

BACKGROUND: Mild and moderate vascular alterations in intestinal biopsies after isolated small bowel transplantation (SBT) have uncertain clinical significance. METHODS: We retrospectively investigated the incidence, association with acute cellular rejection (ACR), treatment, and outcome of mild and moderate vascular changes in 15 adult SBTs performed between December 2000 and October ...

OBJECTIVE: The purpose of this study was to demonstrate the ultrasonographic (US) findings of rupture and the healing process of the medial head of the gastrocnemius ("Tennis Leg"). MATERIALS AND METHODS: Twenty-two patients (age range: 30 to 45 years) with clinically suspected ruptures of the medial head of the gastrocnemius ...

BACKGROUND: Crushing head injuries (CHI) are caused by static loading. This static force slowly deforms a cranium and damages some intracranial components. Severe CHI is usually fetal but substantial brain damage may not be recognized in some patients. In this article, we report seven patients who sustained CHI and analyzed ...

BACKGROUND: Prehospital management of traumatic brain injury (TBI) and trauma system development and organization are aspects of TBI care that have the potential to significantly impact patient outcome. This multi-center study was conducted to explore the effect of prehospital management decisions on early mortality after severe TBI. METHODS: This report ...

BACKGROUND: The role of ultrasound (US) as a screening tool for the evaluation of blunt abdominal trauma is still controversial. Determining the types of missed injuries and the accuracy of US in patients with a low GCS will improve the evaluation of these blunt trauma patients. METHODS: Prospectively collected data ...

Reactive oxygen species have been implicated in the etiology of multiple organ dyspepsia syndrome and infection's complications in patients with trauma. But the oxidative stress and antioxidants levels in abdominal trauma have not yet been studied. Therefore, this study was planned to measure lipid peroxidation for oxidative stress and reduced ...

OBJECTIVE: To determine the sensitivity of conventional sensory assessment in monitoring lingual nerve recovery subsequent to third molar surgery and to evaluate if the assessment methods can be predictive of injury outcome. METHOD: A prospective case series of 94 patients presenting with lingual nerve injuries evaluated using objective mechanosensory and ...

BACKGROUND: To examine risk factors associated with water sports-related cervical spine injuries (WSCSI). METHODS: A retrospective analysis of all patients admitted for WSCSI from 1993 to 1997 was performed. The severity of cervical spine injury was assessed by review of medical records and imaging studies. Mechanisms of injury and activities ...

OBJECTIVE: To investigate whether whiplash injury may be a trigger for the onset of fibromyalgia (FM). METHODS: One hundred fifty-three patients presenting to the emergency room with the diagnosis of whiplash injury were examined. The control group included 53 patients hospitalized with fractures of the limbs, spine, and ribs due ...

This study compares the effect of a daily gauze dressing with that of a lipido-colloid dressing on the time taken to make up the dressing and efficacy of the management of traumatic digital wounds. This is a randomized controlled trial of 28 patients (16 experimental and 12 control) with injuries ...

OBJECTIVE: To describe the demographics, presenting complaints, diagnoses, and disposition of adults presenting to an Australian pediatric emergency department. It was hypothesized that most patients would be younger than 20 years, with low acuity complaints predominantly related to minor injuries resulting in a low admission rate. METHODS: A prospective cohort ...

OBJECTIVES: An increase in mortality has been reported with early intubation in severe traumatic brain injury, possibly due to suboptimal ventilation. This analysis explores the impact of early ventilation on outcome in moderate to severe traumatic brain injury. DESIGN: Retrospective, registry-based analysis. SETTING: This study was conducted in a large ...

Resistance to glucocorticoid (GC) treatment in some patients with idiopathic nephrotic syndrome (INS) is a significant clinical problem. Heat shock protein 90 (HSP90) is the chaperon protein of the GC receptor, which is supposed to be the key factor of GC response. Therefore, we conducted this study to define the ...

BACKGROUND: Acute hyperglycemia is associated with adverse outcome in critically ill patients. Glucose control with insulin improves outcome in surgical intensive care unit (SICU) patients, but the effect in trauma patients is unknown. We investigated hyperglycemia and outcome in SICU patients with and without trauma. METHODS: A 12-year retrospective study ...

OBJECTIVE: This study examined a cohort of pediatric patients treated for suspected corrosive injury of the oesophagus in the ENT department between 1994 and 2003. METHODS: During the study period we examined 337 patients. All patients were treated according to an individual diagnostico-therapeutic protocol that included: foremost, early rigid oesophagoscopy; ...